Anesthesiology
-
Randomized Controlled Trial Multicenter Study
Retesting the Hypothesis of a Clinical Randomized Controlled Trial in a Simulation Environment to Validate Anesthesia Simulation in Error Research (the VASER Study).
Simulation has been used to investigate clinical questions in anesthesia, surgery, and related disciplines, but there are few data demonstrating that results apply to clinical settings. We asked "would results of a simulation-based study justify the same principal conclusions as those of a larger clinical study?" ⋯ The results of our simulated randomized controlled trial justified the same primary conclusion as those of our larger clinical randomized controlled trial, but not a finding of equivalence in effect size.
-
Observational Study
Does a Platelet Transfusion Independently Affect Bleeding and Adverse Outcomes in Cardiac Surgery?
Conflicting results have been reported concerning the effect of platelet transfusion on several outcomes. The aim of this study was to assess the independent effect of a single early intraoperative platelet transfusion on bleeding and adverse outcomes in cardiac surgery patients. ⋯ In this retrospective analysis, cardiac surgery patients receiving platelet transfusion in the operating room experienced less blood loss and more often required vasoactive medication, prolonged ventilation, prolonged intensive care, and blood products postoperatively. However, early platelet transfusion was not associated with reinterventions, thromboembolic complications, infections, organ failure, or mortality.
-
An association between perioperative hyperglycemia and adverse outcomes has been established in surgical patients, - with morbidity being reduced in those treated with insulin.- A practical treatment algorithm and literature summary is provided for surgical patients with diabetes and hyperglycemia.
-
Historical Article
An Anesthesiologist's Perspective on the History of Basic Airway Management: The "Artisanal Anesthetic" Era: 1846 to 1904.
This second installment of the history of basic airway management covers the early-artisanal-years of anesthesia from 1846 to 1904. Anesthesia was invented and practiced as a supporting specialty in the context of great surgical and medical advances. ⋯ Positive-pressure ventilation and intubation stayed at the fringes of medical practice, and airway techniques and devices were developed by trial and error. At the beginning of the 20th century, airway management and anesthetic techniques lagged behind surgical requirements.